Intro To Pt

Front 1

First Party Reimbursement

Back 1

The Patient

Front 2

Second Party Reimbursement

Back 2

The Physical Therapist

Front 3

Third Party Reimbursement

Back 3

The Insurer

Front 4

Capitation

Back 4

Form of reimbursement which pays the provider a fixed amount for each patient in their care

Front 5

Fee-for Service

Back 5

A service provided will be charged to and paid for by the third party payer

Front 6

Managed Care

Back 6

Contains health care costs by controlling the provision of benefits and services

Front 7

Health Maintenance Organization (HMO)

Back 7

Tries to control health care expenditures by focusing on comprehensive medical care which is preventative in nature

Front 8

Copayment

Back 8

Amount to be paid by the patient to health care professionals

Front 9

Deductible

Back 9

A portion of medical costs to be paid by the patient before insurance benefits

Front 10

CPT 2010 (Current Procedural Terminology)

Back 10

Contains five character numeric codes assigned to almost every health care service

Front 11

Eligibility

Back 11

The process of determining whether a patient qualifies for benefits based on factors such as enrollment date, preexisting conditions, and valid referrals

Front 12

Part A Medicare

Back 12

(Hospital Insurance) Helps cover inpatient care in hospitals, critical access hospitals, and SNFs not including LTC

Front 13

Part B Medicare

Back 13

(Medical Insurance) Helps cover MD services, outpatient care, PT, OT, home health care, and supplies if medically necessary

Front 14

Part C Medicare

Back 14

Health plans offered by private companies approved by medicare which are associted with additional monthly premiums

Front 15

Part D Medicare

Back 15

(Rx Drug coverage) Available to those on Medicare at an additional cost

Front 16

Staff HMOs

Back 16

This is where the health care provider is an employee of the HMO providing care only to HMO members

Front 17

Group HMOs

Back 17

Health care is provided by a seperate group of physicians. They have contracts to treat only the members of HMO

Front 18

Individual practice associations (IPAs)

Back 18

Have contracts between the HMO and the individual physicians stipulating that the physcians can use their oown offices to treat HMO and non HMO patients

Front 19

Network HMOs

Back 19

Are siilar to IPA HMOs with one exception. Instead of contracts with individual physicians, the HMO has contacts with a number of large physicians groups who treat HMO as well as non HMO patients

Front 20

Research

Back 20

Creative process by which pprofessionals systematically challenge their everyday practice

Front 21

Experimental Research

Back 21

At least one independent variable is subject to controlled manipulation

Front 22

Non Experimental research

Back 22

Does not manipulate the independent variable

Front 23

True Experimental Design

Back 23

The researcher uses at least two seperate groups of subjects with random assignment of subjects to groups. Experimental and control group

Front 24

Quasi Experimental Group

Back 24

Uses a single group without having a control group

Front 25

Independent Variable

Back 25

Something that is manipulated by the researcher

Front 26

Dependent Variable

Back 26

Believed to change by the influence of the independent variable

Front 27

Non Experimental Research

Back 27

Involves no manipulated of independent variables

Front 28

Correlational Research

Back 28

Attempts to determine whether a relationship exists between two or more quantifiable variables and to what degree

Front 29

Hypothesis

Back 29

A statement of the expected reltionship between variables

Front 30

Reliabiity

Back 30

The degree of consistency to which an instrument measured a variable

Front 31

Intrarater Reliability

Back 31

The degree to which one rater can obtain the same rating for a given variable

Front 32

Interrater reliabilty

Back 32

The degree to which two or more raters can obtain the same rating for a given variable

Front 33

Validity

Back 33

This is how meaningful test scores are as they are used for specific purposes

Front 34

Internal Validity

Back 34

The degree to which the observed differences on the dependent variable are the direct result of manipulation of the independent variable

Front 35

External Validity

Back 35

The degree tto which the results are generalizable to individuals outside of the experimental study. It is the extent to which the resultts of a study can be generalized to other situations and to other people